Brief Overview about Obstructive Sleep Apnea Management

Abstract

The obstructive sleep apnea (OSA) results from interaction between the unfavorable anatomic upper airway susceptibility and the sleep-related changes in upper airway function.  The wakeful state provides compensatory neuronal activation of dilator muscles of the hypopharynx. At sleep onset, this activation will be lost. Thus, in an anatomically compromised collapsible pharynx, the airway narrows and/or collapses resulting in a degree of OSA.The simplest treatment for OSA in obese patients. Even a 10 % weight loss may eliminate apneic episodes by reducing the mass of the posterior airway. Unfortunately, a small fraction of people can permanently lose weight.The nasal continuous positive airway pressure (n-CPAP) can be used, even at home. The patient wears a quietly fitted nasal mask attached to a fan that blows air into the nostrils to keep the collapsed pharyngeal tissue open and improve airflow during sleep. Effective delivery pressures are usually titrated in the sleep laboratory.Surgical treatment of hypo-pharyngeal area are designed to prevent tongue collapse into the airway during sleep. Although obstruction at the base of the tongue level is surgically challenging, multiple techniques have been used. They include tongue reduction procedures, such as midline glossectomy, lingualplasty, lingual tonsillectomy, and radiofrequency reduction, or tongue advancement/stabilization procedures, such as GA, HS, and tongue suspension.